The use of bidirectional barbed suture during robotic assisted radical prostatectomy : impact on the perioperative and functional outcomes

Bidirectional barbed self-retaining sutures represent a new advancement in the application of suture materials used in reconstructive urology. This analysis represents our preliminary effort to examine the intraoperative, postoperative and intermediate functional outcome of bidirectional sutures during robot assisted radical prostatectomy (RARP). Materiali e metodi Between January 2008 and December 2010, 2168 RARP procedures were performed at our institution by a single surgeon (VP). In this cohort there were 97 patients in whom a bidirectional-barbed suture (AngiotechQuill™) was used for bladder neck reconstruction, posterior reconstruction and urethrovesical anastomosis (Group 1). These 97 patients were then computer-matched using multivariable analysis to those who did not undergo bidirectional-barbed suture during the procedure (Group 2). Retrospective analysis of the perioperative and functional outcomes was conducted. Risultati There were no differences between the preoperative clinical and demographic variables between the two matched groups. The anastomosis subjectively evaluated by the surgeon was easier in the group 1 ( Discussione barbed suture have been recently introduced with the aim of make it easier for the surgeons to perform sutures, particularly anastomosis. Also in the hands of an experienced and skilled operator, barbed suture make sutures faster. Conclusioni Usage of bidirectional barbed suture during RARP results in easier and quicker urethrovesical anastomosis and in a lower incidence of radiologic urinary leakage. These preliminary results are encouraging and provide the impetus to conduct further studies with an increased sample size to more clearly define the outcomes in the use of Quill bidirectional barbed suture.